Surgical weight loss more effective at reducing obesity-related cancer and death compared to non-surgical weight loss, new study claim

It’s no secret that obesity poses a risk to health and well-being.

Although diet and activity can help facilitate weight loss, some individuals turn to surgery, also known as bariatric surgery. 

A new study published in JAMA highlights the potential benefits of opting for bariatric surgery versus natural weight loss.¹

Obesity is associated with higher cancer and mortality rates

Obesity can make individuals more prone to developing cancer when compared to non-obese individuals.²

For instance, for esophageal adenocarcinoma, or cancer of the esophagus, overweight, obese, and severely obese individuals are 1.5, 2.4-2.7, and 4.8 more times likely to develop this type of cancer.^2,3 

The National Heart Lung and Blood Institute uses Body Mass Index (BMI) to classify individuals as underweight, healthy, overweight, obese, or severely obese.² These values are <18.5, 18.5-24.9, 25.0-29.9, 30.0-39.9, and >40.0, respectively.

BMI is calculated by dividing weight (in kilograms) by height squared (in meters squared).²

For more information on how obesity impacts cancer risk, visit The National Cancer Institute here.

Similarly, mortality risk increases with weight gain. A 2018 study, also published in JAMA, found that individuals who had once been overweight or obese had a significantly greater mortality rate than those who had always been at a healthy weight.⁴

Of course, lifestyle changes can help with weight loss, but a more drastic surgical approach could also help.

Examples of bariatric surgery include gastric bypass, lap banding, biliopancreatic diversion with duodenal switch, and sleeve gastrectomy. All work to reduce the volume of food intake so less calories are consumed in one sitting.⁵

Bariatric surgery was associated with more weight loss overall 

The Cleveland Clinic study included patients with a BMI greater than 35 who had bariatric surgery between 2004 to 2017 in the U.S.¹

For each surgical patient, five obese patients who did not undergo surgery were included; 5,053 surgical and 25,265 non-surgical patients were included in total.

Participants in the surgical group received either gastric bypass or sleeve gastrectomy procedures only. 

At 10-year follow up, the surgical group showed a 19.2% greater weight loss than the non-surgical group.¹ 

Cancer and mortality risks were lower in surgical group

When comparing surgical versus non-surgical incidences of obesity-related cancer, researchers noticed a significant reduction in cancer risk in the surgical group.

Specifically, at a 10-year follow-up, the surgical group was calculated to be 32% less likely to develop obesity-related cancer.¹ 

In terms of mortality risk, the surgical group was calculated to be at a 48% lower mortality risk.¹ 

But is bariatric surgery the safest option?

Bariatric surgery does not come without risks of its own.

Some risks include nutritional deficiencies, bleeding, intestinal blockage, heartburn, hernia formation, gallstones, and even heart attacks and blood clotting.⁵ 

References

1. Aminian, A. et al. (2022). Association of bariatric surgery with cancer risk and mortality in adults with obesity. JAMA. Published online June 3, 2022. Doi: 10.1001/jama.2022.9009.
2. Obesity and Cancer. (2022). National Cancer Institute and the National Institutes of Health. Accessed Jun. 11, 2022. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet.
3. Hoyo, C. et al. (2012). Body mass index in relation to oesophageal and oesophagogastric junction adenocarcinomas: a pooled analysis from the International BEACON Consortium. International Journal of Epidemiology; 41(6): 1706-1718. Doi: 10.1093/ije/dys176.
4. Xu, H. et al. (2018). Association of obesity with mortality over 24 years of weight history findings from the Framingham Heart Study. JAMA; 1(7): e184587. Doi: 10.1001/jamanetworkopen.2018.4587.
5. Choosing a Bariatric Surgery Procedure. (n.d.). Health Encyclopedia. University of Rochester Medical Canter. Accessed Jun. 11, 2022. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=135&contentid=82.

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